The role of exercise in managing menopause

Menopause is a natural phase in a woman's life, marking the end of her reproductive years. This transition brings about significant biological and physiological changes, which can impact various aspects of health. Understanding these changes and the ways in which exercise can help manage symptoms, can be another way to help maintain wellbeing during this time.

Hormonal changes and their impact

During menopause, a woman’s body experiences significant changes due to the drop in estrogen and progesterone levels. These hormones play key roles in maintaining health by regulating weight, supporting strong bones, and protecting the heart. As their levels decrease, women may face challenges such as weight gain, mood swings, bone loss, and an increased risk of heart disease. Recognizing these changes is important for taking steps to manage symptoms and maintain health during this stage of life.

In particular, estrogen regulates metabolism, maintains bone density, and supports heart health. When levels drop during menopause, women may experience weight gain, bone loss, mood swings, and a higher risk of heart disease.

Progesterone helps balance fluids, supports bone health, and regulates mood and sleep. Its decline during menopause can lead to bloating, bone loss, irritability, and increased cardiovascular risks.

Changes in body composition

Menopause often brings about noticeable changes in body composition. Many women experience an increase in visceral fat, fat that is stored around organs, as well as a decrease in lean muscle mass which impacts metabolism. This shift can increase the risk of cardiovascular issues and contribute to other health concerns.

Osteoporosis and Osteopenia

Osteoporosis affects approximately one in ten women over the age of 60 globally. This condition, characterized by decreased bone mineral density, becomes more prevalent as estrogen levels decline. Women with MS are particularly vulnerable due to their higher risk of falls, so maintaining bone health through appropriate exercise is especially important.

Cardiovascular and metabolic health

The drop in estrogen levels often leads to higher LDL cholesterol and lower HDL cholesterol, increasing heart disease risk. Additionally, decreased insulin sensitivity can raise blood sugar levels, raising the risk of type 2 diabetes. These changes highlight the importance of a heart-healthy diet and regular exercise to manage cardiovascular and metabolic health during menopause.

The role of exercise in managing menopause symptoms

Exercise can play a role in how you manage the various symptoms of menopause. These are the areas that exercise can support managing wellbeing:

• Weight management: Helps prevent and manage weight gain by boosting metabolism and reducing visceral fat.
• Bone health: Weight-bearing and resistance exercises enhance bone density, reducing the risk of osteoporosis.
• Muscle mass: Maintains and builds lean muscle mass, which can decline with menopause.
• Cardiovascular health: Improves heart health by lowering LDL cholesterol and increasing HDL cholesterol.
• Metabolic function: Enhances insulin sensitivity and helps stabilize blood sugar levels, reducing the risk of type 2 diabetes.
• Mood and sleep: Supports better mood and improves sleep quality, counteracting mood swings and sleep disturbances associated with hormonal changes.

Please note: Due to risk of injury please consult a relevant health care professional such as an Exercise Physiologist prior to commencing any strength training programs if you have been told by your doctor you have osteopenia or osteoporosis.

Exercise and brain health in multiple sclerosis

Exercise is especially important for women with MS. It enhances cognitive function, promotes neuroplasticity, and reduces inflammation and oxidative stress. Exercise supports dopamine production, which is thought to help reduce the severity of MS symptoms, and increases Brain-Derived Neurotrophic Factor (BDNF), which is thought to be protective against cognitive decline.

Exercise recommendations

• Aerobic: 3-5 times per week, at a moderate to vigorous intensity. Activities such as walking, cycling, and swimming can improve cardiovascular health, endurance, and mood.
• Strength: 2-3 times per week, at moderate intensity. Weightlifting, resistance bands, and bodyweight exercises can help preserve muscle mass, strengthen bones, and improve functional abilities.
• Flexibility: Daily or as needed, at light to moderate intensity. Stretching, yoga, and Pilates enhance range of motion, reduce muscle stiffness, and improve balance.

Although recommendations exist for exercise types, durations, and intensities, it is important to recognize that progress can be gradual. Transitioning from minimal physical activity to meeting the recommendations can be challenging, therefore health professionals, such as exercise physiologists, are able to assist in gradually increasing tolerance and adapting exercise routines accordingly.

How do allied health professionals help?

Introducing allied health professionals into your care team ensures that exercise programs are tailored to your individual needs and conditions, particularly for those with specific concerns like bone mineral density loss, weight management or cardiovascular health concerns such as high blood pressure. In addition, Exercise Physiologists often work in collaboration with other allied health professionals such as dieticians and physiotherapists, providing a holistic approach to your individualised care. Professional guidance therefore supports safe progression and long-term management, helping you achieve and maintain optimal health.

Incorporating regular exercise into your routine is a proactive step toward managing menopause symptoms and the associated health changed. You can reach out for support with your exercise journey by getting in touch with an MS Plus Exercise Physiologist or Physiotherapist.

Creating a sustainable exercise routine

Developing a sustainable exercise routine is essential for long-term health benefits. Here are some key considerations:

• Personalisation and progression: Having a tailored exercise program your individual fitness levels, preferences, and goals is vital. Building up and having gradual progression under professional guidance, such as an Exercise Physiologist, ensures safety and effectiveness.
• Consistency: Engaging in regular exercise is more beneficial than the occasional intense session. Having a balanced mix of aerobic, strength, and flexibility exercises is ideal to help maintain wellbeing.
• Independent management: With professional guidance, you can transition to self-management which can be can be empowering. Having a check in with your allied health professional can also ensure that you are continuing to meet your health goals.

Menopause can be a time of changing health and challenges for women with MS; however, it can also bring opportunities for improving your overall health and wellbeing. Understanding how menopause can impact the body, and the role that exercise can play in helping to manage symptoms, empowers you to embrace a proactive approach to your health. By integrating targeted exercise routines and seeking tailored support from allied health professionals, including support from an exercise physiologist and dietician, you can enhance your quality of life, manage symptoms more effectively, and embrace this transition with confidence and resilience.

Women's Health Resource

This article was developed in collaboration with MS Plus Exercise Physiologist Talita Welmans as part of a comprehensive Women’s Health Resource designed for women living with MS, addressing key topics such as family planning & pregnancy, and menopause. This project was developed in collaboration with women living with MS.
To explore the full resource, visit: https://www.msplus.org.au/wome...